Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jian She Road, Zhengzhou, 450052, China.
World J Surg Oncol. 2024 Oct 10;22(1):272. doi: 10.1186/s12957-024-03546-8.
A majority of esophageal carcinoma patients are diagnosed at an advanced stage and are no longer suitable for surgical resection. Drug-eluting beads transarterial chemoembolization (DEB-TACE) with oxaliplatin-loaded CalliSpheres beads (CB) have been used for advanced hepatocellular carcinoma and lung cancer, but they have not been reported for the treatment of unresectable or recurrent esophageal carcinoma.
DEB-TACE was performed on 22 patients with unresectable or recurrent esophageal carcinoma between March 2019 and May 2022. The clinical outcomes, complications, and efficacy were retrospectively recorded and analyzed.
A total of 39 sessions of DEB-TACE were performed in 22 patients, with a technical success rate of 92.3% and clinical success rate of 65.0%. No severe complications such as procedure-related death, esophageal rupture or paraplegia were observed. Complete response, partial response, and stable disease were observed in 14.3% (2/14), 42.9% (6/14), and 21.4% (3/14) of patients 6 months after DEB-TACE, respectively. The objective response rates were 62.5%, 42.9% and 57.1% respectively at 1-, 3-, and 6-month after DEB-TACE. Subsequent interventional treatments were administered to 12 patients, including DEB-TACE for hepatic metastasis in 3 (13.6%), esophageal stenting in 5 (22.7%), and airway stent placement in 5 (22.7%). Two patients were lost to follow up. A total of 9 patients died due to tumor progression (n = 5), pneumatic infection (n = 1), and tumor-related massive esophageal hemorrhage (n = 3). The median overall survivals were 13.9 months and 26.5 months from the first session of DEB-TACE and the diagnosis of esophageal carcinoma, respectively.
DEB-TACE with oxaliplatin-loaded CB is suggested as a safe and effective treatment of unresectable or recurrent esophageal carcinoma, and more studies are required to confirm its efficacy and safety.
大多数食管癌患者在晚期被诊断出来，不再适合手术切除。载奥沙利铂的 CalliSpheres 微球（CB）药物洗脱微球栓塞化疗栓塞术（DEB-TACE）已用于治疗晚期肝癌和肺癌，但尚未用于治疗不可切除或复发性食管癌。
2019 年 3 月至 2022 年 5 月，对 22 例不可切除或复发性食管癌患者进行 DEB-TACE 治疗。回顾性记录和分析临床疗效、并发症和疗效。
22 例患者共进行 39 次 DEB-TACE 治疗，技术成功率为 92.3%，临床成功率为 65.0%。未观察到与手术相关的死亡、食管破裂或截瘫等严重并发症。DEB-TACE 后 6 个月，完全缓解、部分缓解和稳定疾病分别为 14.3%（2/14）、42.9%（6/14）和 21.4%（3/14）。DEB-TACE 后 1、3、6 个月的客观缓解率分别为 62.5%、42.9%和 57.1%。随后对 12 例患者进行了介入治疗，包括对 3 例肝转移患者进行 DEB-TACE（13.6%）、5 例食管支架置入术（22.7%）和 5 例气道支架置入术（22.7%）。2 例患者失访。共有 9 例患者因肿瘤进展（n=5）、气性感染（n=1）和肿瘤相关的大量食管出血（n=3）死亡。从 DEB-TACE 第一次治疗到食管癌诊断，中位总生存期分别为 13.9 个月和 26.5 个月。
载奥沙利铂 CB 的 DEB-TACE 被认为是一种治疗不可切除或复发性食管癌的安全有效的方法，需要更多的研究来证实其疗效和安全性。
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